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Clinical factors influencing implant positioning by guided surgery using a nonmetal sleeve template in the partially edentulous ridge: Multiple regression analysis of a prospective cohort
Author(s) -
Park JinYoung,
Song Young Woo,
Park SeungHyun,
Kim JangHyun,
Park JiMan,
Lee JungSeok
Publication year - 2020
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.13664
Subject(s) - apex (geometry) , confidence interval , maxilla , ridge , medicine , dentistry , orthodontics , implant , nuclear medicine , mandible (arthropod mouthpart) , absolute deviation , cone beam computed tomography , computed tomography , surgery , mathematics , anatomy , geology , paleontology , genus , botany , biology , statistics
Abstract Objective To determine the positional accuracy of implants placed with a three‐dimensionally printed template having nonmetal sleeves and to determine the contributing factors to observed deviations. Materials and Methods One hundred and eighty‐seven implants placed in 72 patients were analyzed. Presurgical intraoral scans and cone‐beam computed tomography images obtained before and after surgery were superimposed, and vertical, angular, platform, and apex deviations were measured between the virtually planned and actually placed positions. A multiple linear regression model was designed for identifying the contributing factors. Statistical significance was set at p < .05, with Bonferroni correction if necessary ( p < .0167). Results A total of 187 implants demonstrated deviations of 0.65 [0.56, 0.75] mm (mean [95% confidence interval]) vertically, 3.59° [3.30°, 3.89°] angularly, 1.16 [1.04, 1.28] mm at platform, and 1.50 [1.36, 1.65] mm at apex. Implants placed in the mandible showed larger angular, platform, and apex deviations compared with those in the maxilla ( p = .049, p = .014 and p = .003, respectively). Implants placed at the third or fourth nearest sites from the most‐distal tooth had larger deviations than those placed at the first or second nearest sites, in vertical, platform, and apical aspects ( p = .015, p = .011 and p = .018, respectively). This was only applicable to free‐ending‐supported templates ( p < .0167), and anchor pin‐supported free‐ending templates ( p < .0167). Conclusion Using a three‐dimensionally printed surgical template with a nonmetal sleeve in the partial edentulous ridge resulted in larger deviations in implants placed in the mandible or distal free‐end third or fourth nearest site.